Medicare Part C are also called Medicare Advantage Plans. They are a form of private health insurance that provides the same coverage as Part A and Part B, however the plan may include additional benefits. A Medicare Advantage (MA) plan replaces your Original Medicare Part A and Part B. MA policies are subsidized by Medicare, which will pay private insurance carriers to administer health services to seniors on these programs. Many plans have very low premiums and in some cases $0 premiums, however, these plans have much higher out of pocket exposure as compared to a Medicare supplement plan (plan comparisons).
To join a MA plan, you will need to be enrolled in both Medicare Part A and Part B. You will continue to pay the monthly premium for Part B. By joining an MA plan you continue to be on Medicare and still have the full privileges and protections that are permitted to all beneficiaries. Your Medicare Advantage plan replaces your Part A, Part B, and in many cases your Part D plan.
What to Consider When Choosing a MA Plan
Medicare Advantage plans are advertised heavily in the media to those new to Medicare. MA plans have their place, however our experience has been that once a senior has to deal with the out of pocket exposure of these plans, seniors want off of them. If you feel like you want to consider a Medicare Advantage plan, ask the following questions:
- How much are co-payments for doctors and specialist?
- What are the percentages that you will pay for various services?
- Does the plan have an annual deductible (the amount you pay to your Advantage plan before your benefits “kick in”)?
- How much is inpatient hospital coverage (can vary greatly from plan to plan)?
- How is out patient surgery covered?
- Are your prescriptions covered under the prescription plan?
- What is the annual out of pocket maximum before the plan covers 100%?
- Are your doctor’s in the plans network? How much, if any, are you covered if your doctor or hospital doesn’t accept the coverage?
- Is the plan an HMO or PPO?
Medicare advantage plans have lots of moving parts, which can trip up a senior who is on a fixed budget. Although they are less in monthly premium than a medicare supplement, we find that one major sickness can wipe out all those savings, while leaving you with large out of pocket exposure ($6,000+ each year).
"...Seniors love Medicare Advantage Plans when they are healthy...Seniors love their Medicare Supplement Plans when they get sick."